Good Faith Estimate
Good Faith Estimate for Therapy Services
**Provider:** Shay DuBois, License Number 1000049, Title Licensed Clinical Social Worker
**Practice Address:**1286 University Ave, #1020, San Diego CA 92103-3312
**Contact Information:** 858 321 6355, shay@overcomeanxietytrauma.com
Service Information
This Good Faith Estimate provides an estimate of the cost of therapy services provided by Shay DuBois. This estimate is required by the No Surprises Act, ensuring transparency for self-pay and uninsured clients regarding potential charges.
**Estimated Rate per Session**: $265.00 (50-minute session)
Anticipated Services and Costs
The number of sessions may vary based on individual needs and therapeutic goals. Below are potential cost scenarios based on commonly recommended frequency and duration of therapy sessions.
| session type | cost per session | estimated cost for 3 months | estimated cost for 6 months | estimated cost for 12 months |
| individual therapy | $265.00 | (weekly 4x/mo) $3180.00 | (weekly 4x/mo) $6360.00 | (weekly 4x/mo) $12720.00 |
Important Notes
– **Duration of Treatment:** Therapy duration and frequency are based on the unique needs and preferences of each client. This Good Faith Estimate reflects common scenarios, but the actual length of therapy may vary.
– **Additional Sessions or Services:** If additional sessions or services are required, this estimate will be updated to reflect those changes.
– **Adjustments:** Should treatment goals or needs evolve, the GFE will be reviewed and updated upon request.
Your Rights
You have the right to receive a Good Faith Estimate before beginning services, and you may request a new GFE at any time if your treatment plan changes. For any billing or estimate questions, please contact us at [Contact Information].